Margin Practices in Oral Cavity Cancer Resections: Survey of American Head and Neck Society Members

Objectives/Hypothesis To investigate the definition of a clear margin and the use of frozen section (FS) among practicing head and neck surgeons in oral cancer management. Study Design Cross‐sectional survey. Methods We designed a survey that was sent to American Head and Neck Society (AHNS) members via an email link. Results A total of 185 (13% of 1,392) AHNS members completed our survey. Most surgeons surveyed (96.8%) use FS to supplement oral cavity squamous cell carcinoma resections. Fifty‐five percent prefer a specimen‐based approach. The majority of respondents believe FS is efficacious in guiding re‐resection of positive margins, with 81% considering the new margin to be negative. More than half of respondents defined a distance of >5 mm on microscopic examination as a negative margin. Conclusions To avoid oral cancer resections that result in positive margins on final analysis, and thus the need for additional therapy, most surgeons surveyed use FS. A majority of surveyed surgeons now prefer a specimen‐based approach to margin assessment. Although there is a debate on what constitutes a negative margin, most surgeons surveyed believe it to be >5 mm on microscopic examination. Level of Evidence 4 Laryngoscope , 131:782–787, 2021